Week 7: Family & Community Violence

Abuse and Violence

• Impact: Affects ~10 million people annually in the U.S.; national health concern.

• Types of Abuse: Economic, physical, sexual, emotional, psychological; affects all ages; mainly by known perpetrators.

• Long-term Effects: Leads to emotional trauma; associated with PTSD, substance use disorders, and depression.

• Phases: Initial violence, remorse, honeymoon phase, tension-building phase.

Clinical Picture of Abuse and Violence

• Injuries: Physical injuries need medical attention; psychological responses vary.

• Emotional Responses: Agitation, distress, withdrawal.

• Disclosure: Often undisclosed due to fear; suppressed anger and resentment.

• Children's Impact: Missed school, internalized blame, ongoing problems.

• Adults' Effects: Feelings of guilt, shame, low self-esteem, risk of depression.

Psychological Impact of Abuse

• Trust Issues: Difficulty trusting others, especially authority figures; ensure clients feel safe.

• Emotional Responses: Erratic or intense emotions.

• Intimate Relationships: Closeness may trigger panic/anxiety.

• Nurse's Approach: Ensure clients feel safe and in control.

Family Violence

• Forms: Includes spousal abuse, neglect, child/elder abuse.

• Common Characteristics: Social isolation, power abuse, substance abuse, and intergenerational violence.

  • Learned Behaviors: Violence patterns are passed down; not all exposed children become violent.

Abuse of Power and Control

• Control Dynamics: Manipulation of various life aspects; belittling victims; increasing violence with independence.

• Homicide Risk: Often by intimate partners, especially during separation.

Abuse of Alcohol or Drug Use

• Link to Violence: Alcohol use disorder is frequently connected to domestic violence.

• Date Rape Drugs (Rohypnol): Rising use in incidents.

Cultural Considerations

Domestic violence prevalent, especially among immigrant women; cultural fears hinder access to services.

Intimate Partner Violence

• Definition: Abuse in emotionally intimate relationships.

• Types: Emotional, physical, sexual; statistics show a significant impact.

• Pregnancy Impact: Violence increases, leading to adverse outcomes.

• Same-Sex Relationships: Reported at similar rates but face unique risks.

Child Abuse

• Definition: Includes physical, neglect, sexual assault; significant prevalence (1 in 4 kids).and

• Perpetrators: Often male relatives; recognizing physical signs is crucial.

  • Physical signs: burns, bruises with an identifiable shape, UTI (sexual abuse), and behavior outside of what is normally expected for age.

  • Bruises may look like belt buckles or teeth marks.

• Interventions: Requires psychiatric evaluation; long-term treatment integration.

Elder Abuse

• Definition: Maltreatment of older adults; significant prevalence (1 in 10 individuals).

• Risk Factors: Chronic health issues, dependency.

• Recognizing Cues: Various signs of neglect and abuse; treatment may involve the legal system.

  • Physical: bruises, fractures, lack of eyeglasses or hearing aids. Denial of food, fluids, medications, or restraint.

    • Note for bruising in various healing stages.

    • In addition to fractures in different areas or healing stages.

  • Financial: unable to afford basic needs due to the abuser.

  • Medical neglect: withholding medical care for acute/chronic illness.

  • Self-neglect: failure to care for oneself.

Sexual Assult or Rape

• Definitions: Rape as nonconsensual intercourse; sexual assault as power exertion.

• Statistical Context: Alcohol often involved; mental consent issues noted.

• Rape Trauma Syndrome: A psychological condition post-assault that can manifest through depression, anxiety, and PTSD.

• Interventions: Rape kits and protocols are placed in emergency settings.

  • Sexual Assault Nurse Examiners (SANE RN)

    • Prophylactic treatments may be given for STI/D prevention, HIV testing, and pregnancy prevention medication.

Community Violence

• School Crime Statistics: Low incidence at schools; various impacts on adolescents.

• Bullying and Hazing: Contribute to mental issues; correlation with severe outcomes (suicide, substance use, self-harm, depression).

Nursing Role

• Respect: Use clients’ preferred names/pronouns.

• Empowerment: Recognize clients' identities.

• Respect Healing Journeys: Avoid labeling or judging clients.

Treatment and Interventions

• Nurse's Role: Identify abuse signs, maintain privacy, and support.

• Legal Measures: Involvement for restraining orders; limitations in prevention.

• Survivor Support: Shelters, therapy options, including psychotherapy and support groups.